Exercise!

Anyone here experience problems with exercise?

They tell me to cut my pump dose down 50% before during and after exercise.

But my bg's spike so much that I pay for it.

Today I was low, so I suspended my pump to midway through my workout, when my bg was in a good range.

Now I'm as high as a kite.

ugg...

But anyway, cutting the pump back for exercise doesn't work for me? Anyone else have problems with this or ideas?

Exercise can be pretty tricky. There are a number of factors that affect your glucose levels when doing physical activity. I do quite a bit of exercise including dragon boating, kayaking, weight lifting, running, biking, rock climbing and more. I found that I had to learn how my body reacts to each activity. For example, I now know that I don’t have to take any action when weight lifting because the physical stress my body goes though raises my glucose, so reducing my basel or eating and increasing my IOC will cause my sugar to spike.

Running, always make me go low - so for this, I reduce my basel by 50% starting about 1 hour before and also eat and increase my IOC from say 1:12 to 1:16.

For me, kayaking will at first spike my level at about an hour and a half into it, and then it will start to drop. So when kayaking, I hold off on reducing my basel until I get in the boat. After about an hour and a half in, I’ll have a snack and will start drinking water with some e-load to maintain my glucose level and energy.

So in short, you have to figure out what affect the activity is going to have on your body by testing and make changes that will help you perform at your best. There is no clear solution to this. Just keep in mind that activities that are more strenuous may tend to make your glucose levels rise because your liver reacts to the stress.

Thank you for the information and advice.
Also your examples will help me a great deal.
Yes, I’ll put all into consideration.
Today I did my pilates ball and then yoga. I think the weight bearing of the yoga may have spiked the blood sugar.
Aerobics however, can bottom me out if I’m not careful.
I also have been trying very hard to watch how I treat my lows. I try to eat fruit and something high fiber or protein.
Anyone have advice on treating low blood sugars which might not add to weight gain?

Hi Jewels

Great question with a very tricky answer.
Here is what I’ve found:
Doing cardio (eliptical, tred mill, running, walking) will generally LOWER my BG levels, UNLESS I over- workout. When I don’t eat properly before doing cardio, my body will start to eat away at muscle tissues and burning fat. While technically burning fat is what we WANT to do when trying to lose weight, for diabetics, burning fat turns into creating ketones and thus, raising BG.

As a diabetic, you can lose weight, but it’s a much slower process. You have to do the cardio to increase your lean muscle and replace fat tissues with muscle instead of simply burning the fat off.

So, instead of burning 500 calories per hour (like I was doing for a while) and getting sick from it, I burn 400 calories per hour (still a strenous workout, but just enough to keep me out of spiking BG range). I have to eat something that will stay in my system for a while, like cheeses and peanut butter before working out too. Then, after working out, something like yogurt or cottage cheese keeps me feeling good.

Since going on my strict low carb diet, though, I’ve been at a loss for what kinds of foods to eat before and after. The peanut butter still works okay, but the cottage cheese and yogurt are pretty much out of the question now.

But… I’m still trying to figure it out.
Hope this helps you some.

INot a doctor, just a diabetic trying to figure it out too)

Cutting your pump dose is probably being extra safe (i.e. cover-your-ass), but should not be necessary. Think of it this way - if you were injecting instead of on a pump you would be unable to cut down on your dose - and MDI diabetics have been getting exercise since Banting and Best. So if cutting your dose causes your BG to spike - then don’t cut your dose and check often to see how its working.

When I was new to diabetes exercise would bring down my BG so I would eat something before I started - or use it to bring down my BG if it was already high. After around 10 years of diabetes I found that exercise had less effect on my BG - now I don’t really see my BG go down much unless I exercise for a long time (say more than a 5 mile run). I do notice the effect of exercise the following day, but I don’t change my basal (lantus), just the amount I bolus (humalog).

When my son was first diagnosed they told me to make sure he had some gatorade every 15 minutes he played soccer. Well, we did that and he was always spiking high and playing games sent him off the roof number wise. Then he started pumping and his Dr. told me that 10 % of the diabetic population spike during athletic activities. Well my son is one of them - but more so during competitions, and then he drops later. He does best wearing his pump during competitive sports - although he doesn’t like to anymore, but his numbers stay within better range when he does that. Unfortunately, he usually disconnects because he doesn’t like kids pulling on him ! ! Maybe you are one of the few that goes higher during activities. My son can play an hour of competitive soccer and never once go low - he usually leaves the field fairly high and then drops 3 hours later !! Nancy

I honestly don’t change much in terms of dose when I go to the gym, I have noticed my sugars spike too. I am careful to not do more than 45 minutes of cardio at a time without jumping off the machine to check my sugar and do something else (weights, stretches, etc). Weight lifting or other muscle exercises can go both ways too. I would carry a juice box with you in case of need, but just see how not changing much at all does for you… it can be surprising!

I’m a little more simplistic - cardio (more than walking, walking gets nothing), 1/2 my basal for the first 30 min and leave it after that.
Weightlifting, 1/2 my basal for the first 30 min, then bolus the basal I lost right after working out - usually 0.5-1 U.
Longer exercise (ie 63 mile bike rides that take me ~5 hr), I’ll cut the basal down by 3/4 for the first hour and monitor frequently after that. I also munch on those rides, twizzler here and there.

I was told that if you do exercise, especially vigourous, then whatever your body produces during exercise, whether it’s adrenaline (which affects BG badly), or other things, can be quite resisitant to insulin, so you may need a bit more.

I was told your muscles produce a form of glucose and that is why BG’s tend to spike when you work out.

in my case , my bg level rises if i play soccer empty stomach and it also rises if i have less insulin in my body. so intialyy i became very confused . now i take 2-3 units short acting and take an apple or about 200 gm of rice before going to field .bg level remains approximately same before and after. just try this way

Nope, not true. Your muscles store a form of glucose called glycogen and this glycogen is the ultimate source of fuel for your muscles. First the glycogen is converted through glycolysis to pyruvate and the pyruvate feeds the so-called “Krebs” cycle creating ATP and feeding your muscles.

The reasons you BG spikes is that your body can react to a “demand” for glucose and if your production of glucose exceeds the uptake, your BG spikes. Exercise can cause a release of hormones like cortisol that tells your body (actually your liver) to produce glucose. And then to complicate matters, in order to take up that glucose, you need insulin, so if you are insulin deficient, that glucose backs up and you get a BG spike.

If you think about this, this is why you are cautioned to not exercise with BG > 250 mg/dl, and in fact the real concern is exercising with no insulin on board.

Your muscles don’t produce glucose. Under stress, your liver will start releasing some of the glucose stores as a response to hormones that are produced form strenuous forms of exercise. This is why activities such as weight lifting tends not to lower your glucose levels and sometimes increases it instead.

My experiance:
Aerobic exercise (swimming laps, walking, hiking, yoga) = lowering bloodsugar over time (as in, once my heart-rate goes up, and then all day)
Anaerobic excercise (Waterskiing,weightlifting, running) = initial spike (from adrenaline) with a low about 45-50 min after I START EXERCISING (often, I am still working out at this point…)

My Endo told me not to suspend my pump while exercising, or when low (unless I’m having trouble getting my sugar up over a long period of time) b/c it will cause high sugars when you are done, since there is about 30-50 min. lag in when insulin hits my system. So suspending once I am low dosent do much good.
As a general rule, I lower my basal by the percentage of exertion I am going to be doing. If I am swimming laps at about 50% of the fastest I can possibly go, I lower my basal by 50%, If I am hiking and pacing myself for a long day (15 min. mile), rather than sprinting up the trail (10-min. mile), I’ll lower my Basal by ~ 35%… you get the picture…

Sometimes, If I’m doing a quick workout I won’t lower my basal at all, but drink a watered-down gatorade while I exercise.

just what I have noticed…

Muscles actually release glucose while exercising them. I struggle with exercise.